BACKGROUND: Physicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates. METHODS:Pregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual behavior change counseling during prenatal care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit. Smoking status was measured by self-report, exhaled carbon monoxide, and urinary cotinine. RESULTS: Compared with usual care, greater proportions of intervention group women reported not smoking at the 36th-week visit (14% vs 10%) and at 1 year postpartum (18% vs 11%), but these differences were not significant. However, significantly greater proportions of intervention group women reported either not smoking or reducing their cigarette consumption by 50% or more at their second visit (43% vs 29%, P = 0.02), at their 36th-week visit (40% vs 25%, P < 0.01), and at 1 year postpartum (26% vs 14%, P = 0.02). CONCLUSIONS:Physician training on how to gain a pregnant smoker's commitment to change her smoking behavior, an office prompt system, and individualized smoking behavior change counseling show promise in reducing smoking during pregnancy and postpartum, but practical methods to assist pregnant smokers between regular prenatal visits, as they attempt to quit, need to be developed.
RCT Entities:
BACKGROUND: Physicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates. METHODS: Pregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual behavior change counseling during prenatal care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit. Smoking status was measured by self-report, exhaled carbon monoxide, and urinary cotinine. RESULTS: Compared with usual care, greater proportions of intervention group women reported not smoking at the 36th-week visit (14% vs 10%) and at 1 year postpartum (18% vs 11%), but these differences were not significant. However, significantly greater proportions of intervention group women reported either not smoking or reducing their cigarette consumption by 50% or more at their second visit (43% vs 29%, P = 0.02), at their 36th-week visit (40% vs 25%, P < 0.01), and at 1 year postpartum (26% vs 14%, P = 0.02). CONCLUSIONS: Physician training on how to gain a pregnant smoker's commitment to change her smoking behavior, an office prompt system, and individualized smoking behavior change counseling show promise in reducing smoking during pregnancy and postpartum, but practical methods to assist pregnant smokers between regular prenatal visits, as they attempt to quit, need to be developed.
Authors: Sarah M Wilson; Amie R Newins; Alyssa M Medenblik; Nathan A Kimbrel; Eric A Dedert; Terrell A Hicks; Lydia C Neal; Jean C Beckham; Patrick S Calhoun Journal: Womens Health Issues Date: 2018-07-27
Authors: Stephen T Higgins; Ira M Bernstein; Yukiko Washio; Sarah H Heil; Gary J Badger; Joan M Skelly; Tara M Higgins; Laura J Solomon Journal: Addiction Date: 2010-09-15 Impact factor: 6.526
Authors: Sarah H Heil; Stephen T Higgins; Ira M Bernstein; Laura J Solomon; Randall E Rogers; Colleen S Thomas; Gary J Badger; Mary Ellen Lynch Journal: Addiction Date: 2008-06 Impact factor: 6.526
Authors: Angela L Stotts; Janet Y Groff; Mary M Velasquez; Ruby Benjamin-Garner; Charles Green; Joseph P Carbonari; Carlo C DiClemente Journal: Nicotine Tob Res Date: 2009-06-24 Impact factor: 4.244